Samish Indian Nation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

29140100 Issued in WA

Legal business name

SAMISH INDIAN NATION

Practice address

2918 Commercial Ave
Anacortes, WA 98221-2738

Phone

(360) 293-6404

NPI assigned

May 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas Wooten

Title

Tribal Chair

Phone

(360) 293-6404

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1790942902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 COMMERCIAL AVE",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212738",
            "telephone_number": "360-293-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 COMMERCIAL AVE",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212738",
            "telephone_number": "360-293-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMISH INDIAN NATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "TRIBAL CHAIR",
        "authorized_official_telephone_number": "360-293-6404"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "29140100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1987123680",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Anacortes, WA
• Providers in Anacortes, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.